RESEARCH ARTICLE
Bipolarization of Risk Perception about the Health Effects of Radiation in Residents after the Accident at Fukushima Nuclear Power Plant Makiko Orita1,2, Naomi Hayashida3, Yumi Nakayama1,2, Tetsuko Shinkawa2, Hideko Urata2, Yoshiko Fukushima5, Yuuko Endo6, Shunichi Yamashita4, Noboru Takamura1*
a11111
OPEN ACCESS Citation: Orita M, Hayashida N, Nakayama Y, Shinkawa T, Urata H, Fukushima Y, et al. (2015) Bipolarization of Risk Perception about the Health Effects of Radiation in Residents after the Accident at Fukushima Nuclear Power Plant. PLoS ONE 10(6): e0129227. doi:10.1371/journal.pone.0129227 Academic Editor: Gayle E. Woloschak, Northwestern University Feinberg School of Medicine, UNITED STATES Received: March 4, 2015 Accepted: May 6, 2015 Published: June 9, 2015 Copyright: © 2015 Orita et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: The authors confirm that, for approved reasons, some access restrictions apply to the data underlying the findings. The data underlying the findings in our study cannot be made public due the nature of ethical approvals for the study from the ethics committee of the Nagasaki University Graduate School of Biomedical Sciences. The data is however available upon request by contacting corresponding author ( [email protected]).
1 Department of Global Health, Medicine, and Welfare, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528523, Japan, 2 Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528523, Japan, 3 Division of Strategic Collaborative Research, Center for Promotion of Collaborative Research on Radiation and Environment Health Effects, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528523, Japan, 4 Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528523, Japan, 5 Hirosaki University School of Health Sciences, Hirosaki 0368560, Japan, 6 Kawauchi Municipal Government, Fukushima 9791201, Japan * [email protected]
Abstract The late health effects of low-dose rate radiation exposure are still a serious public concern in the Fukushima area even four years after the accident at Fukushima Daiichi Nuclear Power Plant (FNPP). To clarify the factors associated with residents’ risk perception of radiation exposure and consequent health effects, we conducted a survey among residents of Kawauchi village in May and June 2014, which is located within 30 km of FNPP. 85 of 285 residents (29.8%) answered that acute radiation syndrome might develop in residents after the accident, 154 (54.0%) residents responded that they had anxieties about the health effects of radiation on children, and 140 (49.1%) residents indicated that they had anxieties about the health effects of radiation on offspring. Furthermore, 107 (37.5%) residents answered that they had concerns about health effects that would appear in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year, 149 (52.2%) residents reported that they were reluctant to eat locally produced foods, and 164 (57.5%) residents believed that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms every day for one year. The present study shows that a marked bipolarization of the risk perception about the health effects of radiation among residents could have a major impact on social well-being after the accident at FNPP.
PLOS ONE | DOI:10.1371/journal.pone.0129227 June 9, 2015
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Bipolarization of Risk Perception in Fukushima
Funding: This study was supported primarily by the research projects on health effects of nuclear disasters of the Ministry of the Environment (http:// www.env.go.jp/en/index.html). Competing Interests: The authors have declared that no competing interests exist.
Introduction On 11 March 2011, a magnitude 9.0 earthquake struck Japan, followed within the hour by the first of a series of tsunamis that hit the coast of the Tohoku region of northern Japan. The natural disaster caused immense damage to infrastructure, the economy, and the very social fabric itself [1]. It also led to severe damage to the Fukushima Daiichi Nuclear Power Plant (FNPP), including core meltdown in the three reactors and the release of large amounts of radionuclides into the air. In response to the accident, the Japanese and Fukushima prefectural governments issued instructions for the evacuation of settlements within a 20-km radius of FNPP just after the accident. Furthermore, beyond that inner circle, certain areas where concerns remained that cumulative doses of radiation might reach 20 mSv per year, were designated Deliberate Evacuation Areas. As a result, almost 110,000 local residents evacuated their homes; many residents voluntarily evacuated outside of Fukushima prefecture entirely [2–5]. Monitoring of food and drinking water by Japanese and prefectural governments began on 16 March 2011. Selected foodstuffs (milk, vegetables, grains, meat, fish, etc.) containing radioactive material that exceeded the provisional regulation values as recommended on 17 March 2011 by Japan’s Ministry of Health, Labour and Welfare were prohibited from distribution on 21 March 2011 and from consumption on 23 March 2011 [1, 4, 5]. In spite of these and other efforts to minimize external and internal radiation exposure doses, 47,149 residents of Fukushima Prefecture have remained evacuated to other prefectures as of August 2014 [6]. Since the accident, measurements of external and internal radiation exposure of residents surrounding the FNPP have been reported by several research institutions; they all suggest that external and internal radiation doses caused by the accident were relatively low and far from any direct health consequence in the general population [7–10]. Nevertheless, the health effects of radiation exposure remain a serious public concern in Fukushima. In May 2014, a popular Japanese cartoon stirred up residents’ anxiety by linking Fukushima to nosebleed, one of the typical manifestations of acute radiation syndrome (ARS) [11]. ARS is an acute illness caused by irradiation of the entire body by a high dose of radiation in a very short period of time (usually a matter of minutes). The typical syndrome of ARS is neurovascular syndrome, gastrointestinal syndrome, haematopoietic syndrome and cutaneous syndrome. During the prodromal period, loss of appetite, nausea, vomiting and diarrhea can occur. However, all of these symptoms usually disappear in a day or two when latent period follows. A period of illness follows can be characterized by predisposition to infection and bleeding related to falling blood counts. Death or a period of recovery follows the period of overt illness. The severity and time sequence of these phases depends on the dose and dose rate, usually ARS can be detected after an acute radiation dose as low as 0.5–1.0 Gy [12]. In the cartoon, the main character, a journalist, notes that the nosebleed that he experienced was caused by radiation exposure during a trip to FNPP. Such misleading information may well affect the public risk perception about the health effects of radiation in Fukushima. From this point of view, it is essential to evaluate the risk perception of the health effects of radiation in residents and to implement a comprehensive risk communication strategy. In this study, we conducted a survey of residents of the frontline village of Kawauchi, which is located less than 30 km from FNPP, to clarify the factors associated with residents’ risk perception of radiation exposure and the consequent health effects.
PLOS ONE | DOI:10.1371/journal.pone.0129227 June 9, 2015
2/9
Bipolarization of Risk Perception in Fukushima
Materials and Methods Study Participants The study was conducted in the village of Kawauchi in Fukushima prefecture in May and June 2014. Kawauchi is located less than 30 km from FNPP and was partially included in the Evacuation Order Area established within a 20-km radius from the FNPP (Fig 1). Almost all residents evacuated the village in the accident’s initial phase. On 31 January 2012, the mayor of the village declared that residents who lived at least 20 km away from FNPP could return to their homes because the Japanese Prime Minister had declared that the FNPP reactors had achieved a state of “cold shutdown” in December 2011 [13]. Since April 2014, all residents who lived within a 20-km radius from the FNPP are permitted to temporarily return to their houses, and in October 2014, the village decided to lift the evacuation order for the area 20 km or less from the FNPP. However, the number of residents who have actually returned to the village is still low. As of January 2015 only 1,581 of 2,739 (57.7%) residents have returned to Kawauchi, with the other residents still living in other cities [13, 14]. We initially distributed questionnaires to the almost 2,500 residents who were 18 years of age or older and lived in the village at the time of the accident. We obtained responses from 332 residents, and after excluding 47 residents for insufficient responses, we included 285 residents (141 men and 144 women) in the analysis. The study was approved by the ethics committee of the Nagasaki University Graduate School of Biomedical Sciences (project registration number 14031395). Before the study, we obtained permission from the village’s municipal government to implement the study.
Questionnaire The questionnaire for this study was developed based on our previous study [15], the mental health and lifestyle survey within the framework of the Fukushima Health Survey [16], and a Q & A that we published for residents of Fukushima Prefecture after the accident [17]. We asked about demographic variables including sex, age at the time of the study, employment status, residential location in the village at the time of the accident, returning to the village or not, living apart from family after the accident, and currently growing rice or vegetables. We included questions to evaluate the risk perception of the health effects of radiation in the survey, such as
Fig 1. Location of Kawauchi in Fukushima. doi:10.1371/journal.pone.0129227.g001
PLOS ONE | DOI:10.1371/journal.pone.0129227 June 9, 2015
3/9
Bipolarization of Risk Perception in Fukushima
the health effects of radiation in children and on offspring and knowledge of the health effects of radiation of living in an environment with 0.23μSv per hour of ambient dose rate for one year (equivalent to 1 mSv per year) and of eating 100 Bq per kg (the current standard regulatory value of foods in Japan. The permissible radiation for mushrooms in Wuropen Union (EU) and USA is 500 Bq/kg and 1200 Bq/kg, respectively) of mushrooms every day for one year (equivalent to 0.05 mSv per year). We also included questions about whether residents thought that ARS might occur in residents due to the FNPP accident, whether they were reluctant to eat rice or vegetables produced in the village, and whether they were reluctant to undergo radiological examinations at a hospital. All questions were evaluated on a four point scale (1 = yes, 2 = probably yes, 3 = probably no, and 4 = no).
Statistical Analysis Answers were divided into two categories; “yes” and “probably yes” as “yes” and “probably no” or “no” as no. We divided age into two categories; 60 y and 61 y. Residential location was divided into two areas according to geographical location within the village. We identified the factors associated with risk perception for the health effects of radiation using the chi-square test. We also conducted logistic regression analysis and calculated odds ratios (OR) to identify the risk perception of the possible occurrence of ARS after the accident. P-values less than 0.05 were considered significant.
Results The average age among study participants (N = 285) was not significantly different between men and women (65.2 ± 16.0 years vs. 64.8 ± 16.6 years, p = 0.86). 171 of the 285 residents (60.0%) have already returned to the village. 85 residents (29.8%) answered that the ARS might develop in residents after the accident at FNPP (Fig 2a), 154 (54.0%) residents answered that they had anxieties about the health effects of radiation on children (Fig 2b), and 140 (49.1%)
Fig 2. Residents’ risk perception of the health effects of radiation: a) “Do you think that that acute radiation syndrome might develop in residents due to radiation exposure following the Fukushima accident?” b) “Do you have anxiety about the health effects of radiation on children?” c) “Do you have anxiety about the health effects of radiation on offspring?” d) “Do you have anxiety that health effects would develop in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year? e) “Are you reluctant to eat rice or vegetables produced in the village?” f) “Do you believe that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms for one year?” doi:10.1371/journal.pone.0129227.g002
PLOS ONE | DOI:10.1371/journal.pone.0129227 June 9, 2015
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Bipolarization of Risk Perception in Fukushima
residents reported that they had anxieties about the health effects of radiation on offspring (Fig 2c). Fig 2d, 2e and 2f show the residents’ anxieties about the health effects of external and internal radiation exposures. 107 (37.5%) residents answered that they were concerned about health effects that would appear in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year (equivalent to 1 mSv per year) (Fig 2d), 149 (52.2%) residents answered that they were reluctant to eat rice or vegetables produced in the village (Fig 2e), and 164 (57.5%) residents believed that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms every day for one year. (equivalent to 0.05 mSv per year) (Fig 2f). 85 respondents (29.8%) answered that ARS had developed due to the accident at FNPP (ARS+) and 200 (70.1%) answered that ARS had not developed due to the accident (ARS-). A significantly lower ARS+ residents than ARS- residents had already returned to the village (48.2% vs. 65.0%, p = 0.012) (Table 1). The following percentages were significantly higher among ARS+ than ARS-: those who had anxiety about the health effects of radiation on children (98.8% vs. 35.0%, p
Bipolarization of Risk Perception about the Health Effects of Radiation in Residents after the Accident at Fukushima Nuclear Power Plant Makiko Orita1,2, Naomi Hayashida3, Yumi Nakayama1,2, Tetsuko Shinkawa2, Hideko Urata2, Yoshiko Fukushima5, Yuuko Endo6, Shunichi Yamashita4, Noboru Takamura1*
a11111
OPEN ACCESS Citation: Orita M, Hayashida N, Nakayama Y, Shinkawa T, Urata H, Fukushima Y, et al. (2015) Bipolarization of Risk Perception about the Health Effects of Radiation in Residents after the Accident at Fukushima Nuclear Power Plant. PLoS ONE 10(6): e0129227. doi:10.1371/journal.pone.0129227 Academic Editor: Gayle E. Woloschak, Northwestern University Feinberg School of Medicine, UNITED STATES Received: March 4, 2015 Accepted: May 6, 2015 Published: June 9, 2015 Copyright: © 2015 Orita et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: The authors confirm that, for approved reasons, some access restrictions apply to the data underlying the findings. The data underlying the findings in our study cannot be made public due the nature of ethical approvals for the study from the ethics committee of the Nagasaki University Graduate School of Biomedical Sciences. The data is however available upon request by contacting corresponding author ( [email protected]).
1 Department of Global Health, Medicine, and Welfare, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528523, Japan, 2 Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528523, Japan, 3 Division of Strategic Collaborative Research, Center for Promotion of Collaborative Research on Radiation and Environment Health Effects, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528523, Japan, 4 Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 8528523, Japan, 5 Hirosaki University School of Health Sciences, Hirosaki 0368560, Japan, 6 Kawauchi Municipal Government, Fukushima 9791201, Japan * [email protected]
Abstract The late health effects of low-dose rate radiation exposure are still a serious public concern in the Fukushima area even four years after the accident at Fukushima Daiichi Nuclear Power Plant (FNPP). To clarify the factors associated with residents’ risk perception of radiation exposure and consequent health effects, we conducted a survey among residents of Kawauchi village in May and June 2014, which is located within 30 km of FNPP. 85 of 285 residents (29.8%) answered that acute radiation syndrome might develop in residents after the accident, 154 (54.0%) residents responded that they had anxieties about the health effects of radiation on children, and 140 (49.1%) residents indicated that they had anxieties about the health effects of radiation on offspring. Furthermore, 107 (37.5%) residents answered that they had concerns about health effects that would appear in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year, 149 (52.2%) residents reported that they were reluctant to eat locally produced foods, and 164 (57.5%) residents believed that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms every day for one year. The present study shows that a marked bipolarization of the risk perception about the health effects of radiation among residents could have a major impact on social well-being after the accident at FNPP.
PLOS ONE | DOI:10.1371/journal.pone.0129227 June 9, 2015
1/9
Bipolarization of Risk Perception in Fukushima
Funding: This study was supported primarily by the research projects on health effects of nuclear disasters of the Ministry of the Environment (http:// www.env.go.jp/en/index.html). Competing Interests: The authors have declared that no competing interests exist.
Introduction On 11 March 2011, a magnitude 9.0 earthquake struck Japan, followed within the hour by the first of a series of tsunamis that hit the coast of the Tohoku region of northern Japan. The natural disaster caused immense damage to infrastructure, the economy, and the very social fabric itself [1]. It also led to severe damage to the Fukushima Daiichi Nuclear Power Plant (FNPP), including core meltdown in the three reactors and the release of large amounts of radionuclides into the air. In response to the accident, the Japanese and Fukushima prefectural governments issued instructions for the evacuation of settlements within a 20-km radius of FNPP just after the accident. Furthermore, beyond that inner circle, certain areas where concerns remained that cumulative doses of radiation might reach 20 mSv per year, were designated Deliberate Evacuation Areas. As a result, almost 110,000 local residents evacuated their homes; many residents voluntarily evacuated outside of Fukushima prefecture entirely [2–5]. Monitoring of food and drinking water by Japanese and prefectural governments began on 16 March 2011. Selected foodstuffs (milk, vegetables, grains, meat, fish, etc.) containing radioactive material that exceeded the provisional regulation values as recommended on 17 March 2011 by Japan’s Ministry of Health, Labour and Welfare were prohibited from distribution on 21 March 2011 and from consumption on 23 March 2011 [1, 4, 5]. In spite of these and other efforts to minimize external and internal radiation exposure doses, 47,149 residents of Fukushima Prefecture have remained evacuated to other prefectures as of August 2014 [6]. Since the accident, measurements of external and internal radiation exposure of residents surrounding the FNPP have been reported by several research institutions; they all suggest that external and internal radiation doses caused by the accident were relatively low and far from any direct health consequence in the general population [7–10]. Nevertheless, the health effects of radiation exposure remain a serious public concern in Fukushima. In May 2014, a popular Japanese cartoon stirred up residents’ anxiety by linking Fukushima to nosebleed, one of the typical manifestations of acute radiation syndrome (ARS) [11]. ARS is an acute illness caused by irradiation of the entire body by a high dose of radiation in a very short period of time (usually a matter of minutes). The typical syndrome of ARS is neurovascular syndrome, gastrointestinal syndrome, haematopoietic syndrome and cutaneous syndrome. During the prodromal period, loss of appetite, nausea, vomiting and diarrhea can occur. However, all of these symptoms usually disappear in a day or two when latent period follows. A period of illness follows can be characterized by predisposition to infection and bleeding related to falling blood counts. Death or a period of recovery follows the period of overt illness. The severity and time sequence of these phases depends on the dose and dose rate, usually ARS can be detected after an acute radiation dose as low as 0.5–1.0 Gy [12]. In the cartoon, the main character, a journalist, notes that the nosebleed that he experienced was caused by radiation exposure during a trip to FNPP. Such misleading information may well affect the public risk perception about the health effects of radiation in Fukushima. From this point of view, it is essential to evaluate the risk perception of the health effects of radiation in residents and to implement a comprehensive risk communication strategy. In this study, we conducted a survey of residents of the frontline village of Kawauchi, which is located less than 30 km from FNPP, to clarify the factors associated with residents’ risk perception of radiation exposure and the consequent health effects.
PLOS ONE | DOI:10.1371/journal.pone.0129227 June 9, 2015
2/9
Bipolarization of Risk Perception in Fukushima
Materials and Methods Study Participants The study was conducted in the village of Kawauchi in Fukushima prefecture in May and June 2014. Kawauchi is located less than 30 km from FNPP and was partially included in the Evacuation Order Area established within a 20-km radius from the FNPP (Fig 1). Almost all residents evacuated the village in the accident’s initial phase. On 31 January 2012, the mayor of the village declared that residents who lived at least 20 km away from FNPP could return to their homes because the Japanese Prime Minister had declared that the FNPP reactors had achieved a state of “cold shutdown” in December 2011 [13]. Since April 2014, all residents who lived within a 20-km radius from the FNPP are permitted to temporarily return to their houses, and in October 2014, the village decided to lift the evacuation order for the area 20 km or less from the FNPP. However, the number of residents who have actually returned to the village is still low. As of January 2015 only 1,581 of 2,739 (57.7%) residents have returned to Kawauchi, with the other residents still living in other cities [13, 14]. We initially distributed questionnaires to the almost 2,500 residents who were 18 years of age or older and lived in the village at the time of the accident. We obtained responses from 332 residents, and after excluding 47 residents for insufficient responses, we included 285 residents (141 men and 144 women) in the analysis. The study was approved by the ethics committee of the Nagasaki University Graduate School of Biomedical Sciences (project registration number 14031395). Before the study, we obtained permission from the village’s municipal government to implement the study.
Questionnaire The questionnaire for this study was developed based on our previous study [15], the mental health and lifestyle survey within the framework of the Fukushima Health Survey [16], and a Q & A that we published for residents of Fukushima Prefecture after the accident [17]. We asked about demographic variables including sex, age at the time of the study, employment status, residential location in the village at the time of the accident, returning to the village or not, living apart from family after the accident, and currently growing rice or vegetables. We included questions to evaluate the risk perception of the health effects of radiation in the survey, such as
Fig 1. Location of Kawauchi in Fukushima. doi:10.1371/journal.pone.0129227.g001
PLOS ONE | DOI:10.1371/journal.pone.0129227 June 9, 2015
3/9
Bipolarization of Risk Perception in Fukushima
the health effects of radiation in children and on offspring and knowledge of the health effects of radiation of living in an environment with 0.23μSv per hour of ambient dose rate for one year (equivalent to 1 mSv per year) and of eating 100 Bq per kg (the current standard regulatory value of foods in Japan. The permissible radiation for mushrooms in Wuropen Union (EU) and USA is 500 Bq/kg and 1200 Bq/kg, respectively) of mushrooms every day for one year (equivalent to 0.05 mSv per year). We also included questions about whether residents thought that ARS might occur in residents due to the FNPP accident, whether they were reluctant to eat rice or vegetables produced in the village, and whether they were reluctant to undergo radiological examinations at a hospital. All questions were evaluated on a four point scale (1 = yes, 2 = probably yes, 3 = probably no, and 4 = no).
Statistical Analysis Answers were divided into two categories; “yes” and “probably yes” as “yes” and “probably no” or “no” as no. We divided age into two categories; 60 y and 61 y. Residential location was divided into two areas according to geographical location within the village. We identified the factors associated with risk perception for the health effects of radiation using the chi-square test. We also conducted logistic regression analysis and calculated odds ratios (OR) to identify the risk perception of the possible occurrence of ARS after the accident. P-values less than 0.05 were considered significant.
Results The average age among study participants (N = 285) was not significantly different between men and women (65.2 ± 16.0 years vs. 64.8 ± 16.6 years, p = 0.86). 171 of the 285 residents (60.0%) have already returned to the village. 85 residents (29.8%) answered that the ARS might develop in residents after the accident at FNPP (Fig 2a), 154 (54.0%) residents answered that they had anxieties about the health effects of radiation on children (Fig 2b), and 140 (49.1%)
Fig 2. Residents’ risk perception of the health effects of radiation: a) “Do you think that that acute radiation syndrome might develop in residents due to radiation exposure following the Fukushima accident?” b) “Do you have anxiety about the health effects of radiation on children?” c) “Do you have anxiety about the health effects of radiation on offspring?” d) “Do you have anxiety that health effects would develop in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year? e) “Are you reluctant to eat rice or vegetables produced in the village?” f) “Do you believe that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms for one year?” doi:10.1371/journal.pone.0129227.g002
PLOS ONE | DOI:10.1371/journal.pone.0129227 June 9, 2015
4/9
Bipolarization of Risk Perception in Fukushima
residents reported that they had anxieties about the health effects of radiation on offspring (Fig 2c). Fig 2d, 2e and 2f show the residents’ anxieties about the health effects of external and internal radiation exposures. 107 (37.5%) residents answered that they were concerned about health effects that would appear in the general population simply by living in an environment with a 0.23 μSv per hour ambient dose for one year (equivalent to 1 mSv per year) (Fig 2d), 149 (52.2%) residents answered that they were reluctant to eat rice or vegetables produced in the village (Fig 2e), and 164 (57.5%) residents believed that adverse health effects would occur in the general population by eating 100 Bq per kg of mushrooms every day for one year. (equivalent to 0.05 mSv per year) (Fig 2f). 85 respondents (29.8%) answered that ARS had developed due to the accident at FNPP (ARS+) and 200 (70.1%) answered that ARS had not developed due to the accident (ARS-). A significantly lower ARS+ residents than ARS- residents had already returned to the village (48.2% vs. 65.0%, p = 0.012) (Table 1). The following percentages were significantly higher among ARS+ than ARS-: those who had anxiety about the health effects of radiation on children (98.8% vs. 35.0%, p
